Salmonella Serovar Enteritidis Infection Caused By Bean Sprouts: Assessing The Extent Of A Recent Multistate Outbreak In The USA Research Paper

Just recently, a new case of multistate outbreak of Salmonella Enteritidis infection was determined in the USA. In total, 115 persons from 12 states were reported to be infected by the S. Entertidis and their distribution is as follows: 36 in Massachusetts, 22 in New York, 18 in Pennsylvania, 8 in Connecticut, 7 in Rhode Island, 6 in Maryland, another 6 in New Hampshire, 4 in Maine, 3 in Ohio, another 3 in Vermont, 1 in Montana, and another 1 in Virginia (CDC “Multistate Outbreak of Salmonella Enteritidis”). Only one person among the 115—the only patient from Montana—was reported traveling to Eastern United States during the time when the exposure to the infection most likely took place (CDC “Multistate Outbreak of Salmonella Enteritidis”). Onset of illness was then assessed and estimated to occur between September 30, 2014 to December 15, 2014, affecting persons aged 1 to 83 years old and averagely those aged 32 years old (CDC “Multistate Outbreak of Salmonella Enteritidis”). It was also discovered that 64% of the infected people were female (CDC “Multistate Outbreak of Salmonella Enteritidis”). Assessing the origin and other details of the outbreak, CDC collaborated with other public health offices as well as with the Food and Drug Administration and found out—after locating five illness clusters from the states of Masachusetts, Rhode Island, and Vermont—that the most likely origin of the outbreak is a batch of bean sprouts included in a meal that most of the patients consumed (CDC “Multistate Outbreak of Salmonella Enteritidis”). Further investigation pointed out a company that processes and manufactures commercial bean sprouts, the Wonton Foods Inc. of Brooklyn and New York (CDC “Multistate Outbreak of Salmonella Enteritidis”). Although none died of the said outbreak, 19 of the 115 infected people were hospitalized and the issue still prompted the temporary cessation of the operations of Wonton Foods Inc. until a more thorough inspection and a series of modifications in their sanitization treatment were actually completed (CDC “Multistate Outbreak of Salmonella Enteritidis”). On November 29, 2014, the company resumed operations and shipment of bean sprouts after completing thorough cleaning and sanitization processes and restarting production on November 24, 2014 (CDC “Multistate Outbreak of Salmonella Enteritidis”).
Salmonella serovar Enteritidis is a variant of the Salmonella entierica bacteria that commonly causes of food-borne contamination and infection (Duynhoven et al. 440; Parker et al. 3723). Salmonella species often contaminate raw meat and other uncooked and undercooked foods (Duynhoven et al. 440). In fact, when it was first detected and considered as a serious health and food supply problem in the 1980s, Salmonella contamination widely affected poultry products (Parker et al. 3723). Salmonella spp. normally resides in the GI tracts of animals—including birds—and is often passed on to other animals and humans through direct or indirect fecal contamination of foods (CDC “Salmonella”). Salmonella contamination in meat usually takes place when the meat is poorly prepared or undercooked (CDC “Salmonella”). Salmonella bacteria that are normally present in meat can cause Salmonella serovar Enteritidis infection if not cooked or prepared properly (CDC “Salmonella”). While it is easy to comprehend the pathway that Salmonella bacteria take in contaminating meat, it is not readily true in the case of eggs. Eggs, being enclosed in a shell made of protein, are widely perceived to be sterile in its natural state and that cooking is not really that necessary since pathogenic entities are unlikely to cross the hard shell. However, the contrary is true. Salmonella contamination in eggs happens despite the presence of shell (CDC “Salmonella”). Eggs that come in contact with fecal matter, which is normally teeming with Salmonella bacteria, become contaminated through the minor and little cracks on shell which the bacteria can use as entry points (CDC “Salmonella”). However, with the highly-improved sanitization processes in poultry farms, such kind of Salmonella contamination route unlikely happens nowadays (CDC “Salmonella”). But eggs are still not completely free from the possibility of getting contaminated as contamination can also occur within the eggs, in contrast with what was explained earlier (CDC “Salmonella”). Contamination of eggs from within often takes place when Salmonella species contaminate the healthy ovaries of hens, making them part of the developing eggs without any conspicuous signs of their presence (CDC “Salmonella”). But aside from eggs and meat, especially chicken meat, Salmonella contamination can also occur in other produce that are often consumed fresh, such as vegetables and fruits (Studer et al. 4613; Duynhoven et al. 440). More surprisingly, Salmonella bacteria can also contaminate dry foods such as raw almonds (Parker et al. 3723).
In response to the annually growing number of people that suffer from various illnesses around the globe, our society has developed an inclination for a healthier lifestyle which includes consumption of more fruits and vegetables (Studer et al. 4613). Conventionally, fruits and vegetables are eaten in their natural state: fresh, raw, uncooked. Aside from the fact that they indeed need little to no heat at all to become palatable, some fruits and vegetables—even those that actually require little cooking—are intentionally consumed fresh and raw due to the conception that cooking blanches the fruits and vegetables of their natural nutrients. While such claim has an incontestable truth to it, cooking may still be essential in keeping our foods bacteria-free (Studer et al. 4613). Leaving and consuming foods uncooked, as stated in earlier paragraph, may lead to various illnesses due to microbial contamination (Duynhoven et al., 440; Studer et al. 4613; Parker et al. 3723). Such illnesses may, in return, lead to vast outbreaks as in the case of the recent multistate Salmonella serovar Enteritidis outbreak in USA.
Bean sprouts, such as mung and alfalfa bean seeds, are among the foods most commonly consumed raw and fresh (CDC “Multistate Outbreak of Salmonella Enteritidis”; Studer et al. 4613). Considered as vegetables, bean sprouts are commonly included in Asian meals and are conventionally served only slightly cooked to preserve the taste and texture (Studer et al. 4613). However, such preparation practice for bean sprouts may promote the occurrence of bacteria such as S. Enteritidis, causing illnesses. To ensure quality, bean sprouts are normally maintained in warm and humid environment to promote their growth—a factor that causes the natural sugar in beans’ germinating seeds to diffuse, offering nutrition and attracting bacterial growth (Studer et al. 4613). Therefore, sprouting bean seeds provide a favorable environment for bacterial growth, further promoting contamination (Studer et al. 4613). The poor practice of leaving bean sprouts uncooked also worsens contamination and increases the chances of illness onset (Studer et al. 4613). To date, Salmonella contamination in bean sprouts is one of the main causes for the development of Salmonella serovar Enteritidis infection outbreak (Studer et al. 4613; Duynhoven et al. 440).
Over the years, sprout-related outbreaks have affected countries worldwide including Denmark, Canada, Finland, France, The Netherlands, Norway, Sweden, United Kingdom, and the United States (Studer et al. 4613). In addition to such countries, Japan was also hit by a sprout-contamination outbreak due to a pathogenic strain of Escherichia coli in 1996 which affected 9,000 individuals and killed a total of 12 (Studer et al. 4613). Aside from Japan, Germany was also among the countries that were largely hit by sprout-contamination outbreak just recently, in 2011 (Studer et al. 4613). Like in the case of Japan, the main bacteria involved in the outbreak in Germany was another strain of Escherichia coli, O104:H4 strain, which infected a total of 4,000 people, including 908 cases of hemolytic uremic syndrome and 50 deaths (Studer et al. 4613). Looking at the documented severity of an outbreak due to food contamination, it is not a wonder why USA has promptly and immediately addressed the emerging outbreak caused by Salmonella contamination in bean sprouts. Although mung and alfalfa bean sprouts are considered as the main culprit behind most of the sprout-related outbreaks in Asia, Europe, and USA, CDC has included other types of bean sprouts, such as clover and radish, as probable causes of Salmonella serovar Enteritidis infection (CDC “Multistate Outbreak of Salmonella Enteritidis”).
Salmonella serovar Enteritidis infection linked to beans sprouts differ from other types Salmonella serovar Enteritidis infection, such as those linked to poultry products, in terms of the species strain involved. Salmonella serovar Enteritidis species that contaminate bean sprouts belong to the serotype classified as phage type 4b by the officials in the Netherlands after an outbreak in the year 2000 (Duynhoven et al. 440). Despite the various strains, Salmonella serovar Enteritidis infection shows uniform symptoms. Affected primarily by gastroenteritis, a person infected by Salmonella bacteria experiences fever, abdominal cramps, and diarrhea starting 12 to 72 hours after exposure to contaminated foods and/or beverages (CDC “Salmonella”). Furthermore, it is also determined that some people have higher risk for acquiring Salmonella serovar Enteritidis infection despite being exposed to relatively lower levels of bacteria compared to what is commonly infective. Such people include the elderly, infants, pregnant women, patients suffering from chronic diseases and those with compromised immune system (CDC “Salmonella”; CDC “Multistate Outbreak of Salmonella Enteritidis”; Duynhoven et al. 442). Salmonella spp. that causes infection is also considered transmissible (Duynhoven et al. 442). As expounded by CDC (“Salmonella”), cross-contamination can happen in kitchen when unwashed hands that came in contact with Salmonella bacteria touch the food or anything that will be used for meal preparation (CDC “Salmonella”). Other foods that are contaminated with Salmonella serovar Enteritidis that come in contact with other foods may also cause infection (Duynhoven et al. 442).
Currently, laws regarding the manufacture, production, and distribution of commercial products that are normally eaten raw are still being monitored and modified to further enhance health safety and management of food contamination. Despite its negative effects, outbreaks indeed opened us and our health system to the various aspects regarding food safety that are still overlooked nowadays. Like in the case of the Netherlands, the outbreak that took place in the year 2000 revealed the need for a stricter laws regarding food safety as applied to raw foods (Duynhoven et al. 442). Before the outbreak, the Netherlands took manufacture and commercialization of raw foods for granted thinking that raw foods will still undergo further treatment and sanitization (Duynhoven et al. 442). But with the outbreak, officials of the country, especially those responsible for food safety, realized that “further treatment and sanitization” are not always reliable especially for commercialized food that are normally consumed raw or uncooked (Duynhoven et al. 442). Applying this to USA, we could say that the country’s capacity to respond immediately to outbreaks, such as that which happened to 12 states and affected 115 people recently, mirrors the efficacy of food safety measures being used today. However, ensuring food safety is a two-way road that requires not just the diligence of authority but also that of food manufacturing companies and people who prepare and consume foods.

Works Cited

Centers for Disease Control and Prevention (CDC). “Multistate Outbreak of Salmonella Enteritidis Infections Linked to Bean Sprouts (Final Update).” CDC (23 Jan. 2015). Web. 15 Feb. 2015.
Centers for Disease Control and Prevention (CDC). “Salmonella serotype Enteritidis infection.” CDC (23 Nov. 2010). Web. 15 Feb. 2015.
Duynhoven, Yvonne T.H.P. van, et al. “Salmonella enterica Serotype Enteritidis Phage Type 4b Outbreak Associated with Brean Sprouts.” Emerging Infectious Diseases 8.4 (2002): 440-443. National Center for Biotechnology Information. Web. 14 Feb. 2015.
Parker, Craig T., et al. “Comparison of Genotypes of Salmonella enterica Serovar Enteritidis Phage Type 30 and 9c Strains Isolated from Three Outbreaks Associated with Raw Almonds.” Applied and Environmental Microbiology 76.11 (Jun. 2010): 3723-3731. Web. 14 Feb. 2015.
Studer, Patrick, et al. “Evaluation of Aerated Steam Treatment of Alfalfa and Mung Bean Seeds To Eliminate High Levels of Escherichia coli O157:H7 and O178:H12, Salmonella enterica, and Listeria monocytogenes.” Applied and Environmental Microbiology 79 (Aug. 2013): 4613-4619. Web. 14 Feb. 2015.